Provider Demographics
NPI:1144931544
Name:REDDICK, LOVEE J (LMSW)
Entity type:Individual
Prefix:MS
First Name:LOVEE
Middle Name:J
Last Name:REDDICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-5117
Mailing Address - Country:US
Mailing Address - Phone:718-230-1379
Mailing Address - Fax:
Practice Address - Street 1:493 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-5117
Practice Address - Country:US
Practice Address - Phone:718-230-1379
Practice Address - Fax:718-638-1628
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112775-01104100000X
NY118248104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY364017324OtherSTATE ID